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Salford Royal Hospitals in Greater Manchester, Oxford University Hospital Trust, University Hospitals Birmingham and Hull and East Yorkshire Hospitals have all admitted restricting surgery for patients living outside their catchment area in the last few months.

Other struggling trusts are likely to follow suit to reduce patient numbers and meet waiting-time targets.

Many patients choose to bypass their local district hospital in favour of a larger teaching trust that specialises in an area of medicine

Last night, Roy Lilley, a health policy analyst and former chairman of an NHS trust, accused hospitals of 'turning off the tap'.

'I'm sure patients will be horrified to learn if they live in the wrong place they won't get treated.

'Because hospitals are more worried about breaching targets and regulators than patients and relatives they are secretly closing their doors to avoid over-running and breaching targets and getting described as failing and being put in special measures.'

Shadow Health Secretary Andy Burnham said: 'Hospitals are turning people away and cancelling operations to cope with the unfolding chaos. The NHS Constitution gives patients clear rights and they are in danger of being breached.'

University Hospitals Birmingham imposed restrictions in September covering non-urgent operations including orthopaedic and general surgery such as slipped discs.

It will only accept patients from within two so-called clinical commissioning groups – local NHS bodies – in the city centre rather than from the suburbs and surrounding counties.

The trust said the 'unprecedented rise' in patients had led to longer waiting times which posed a risk to those needing more urgent heart or liver surgery.

Salford Royal stopped accepting patients for hip and knee replacements and skin cancer procedures if they live closer to another hospital. Oxford University Hospitals Trust is turning away patients who need spinal operations, while Hull and East Yorkshire is doing the same for neurosurgery.

The restrictions were uncovered by the Health Service Journal using Freedom of Information requests.

All four trusts said demand had 'increased significantly' in the past few years and that the restrictions were a temporary measure while they cleared a backlog.

But Katherine Murphy, of the Patients Association, said: 'The NHS must abide by its own rules and provide the services to patients which they are legally obliged to provide.' The restrictions are further evidence that the NHS is struggling to meet the needs of the rising and ageing population.

Waiting times for operations are at their highest for more than six years and hospitals will come under further pressure over the winter, when health bosses are braced for an expected surge in cases of chest infections, flu and norovirus.

The NHS's medical director Professor Bruce Keogh also urged the public to go to their pharmacy instead of A&E wherever possible to prevent overcrowding.

The chief executive of an NHS trust in the West Midlands warned of severe overcrowding as he suddenly resigned this week.

A Department of Health spokesman said: 'While we understand the pressures that the NHS is under, all patients have the right to choose where they are treated and we expect all trusts to respect these decisions.'